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Minimum alveolar concentration of sevoflurane for tracheal extubation in children
Insights
The minimum alveolar concentration of sevoflurane to prevent coughing or movement during tracheal extubation in children is 2.3%. This finding helps reduce respiratory complications in pediatric anesthesia.
Area of Science:
- Anesthesiology
- Pediatric Medicine
- Respiratory Care
Background:
- Tracheal extubation during deep anesthesia reduces respiratory complications.
- Sevoflurane is an effective anesthetic for pediatric procedures.
- Determining optimal anesthetic concentrations is crucial for patient safety.
Purpose of the Study:
- To determine the minimum alveolar concentration (MACextubation) of sevoflurane needed to prevent coughing or movement during tracheal extubation in children.
- To establish a safe and effective sevoflurane dosage for pediatric extubation.
Main Methods:
- A randomized study involving 30 nonpremedicated children (aged 2-10 years) undergoing plastic surgery.
- Children were divided into five groups receiving different end-tidal sevoflurane concentrations (2.0% to 4.0%).
- MACextubation was determined using logistic regression after discontinuing nitrous oxide and maintaining sevoflurane in oxygen.
Main Results:
- The calculated MACextubation for sevoflurane was 2.3% (standard error 0.2%).
- The 95% confidence limits for MACextubation were 1.2% and 2.7%.
Conclusions:
- An end-tidal sevoflurane concentration of 2.3% allows for tracheal extubation without coughing or movement in 50% of anesthetized children aged 2-10 years.
- This concentration can aid in minimizing respiratory complications during pediatric extubation.
Background:
One advantage of tracheal extubation during deep anaesthesia is that respiratory complications are reduced. Sevoflurane is a suitable anaesthetic agent for children. This study was conducted to determine the minimum alveolar concentration of sevoflurane required to prevent cough or movement during and after tracheal extubation (MACextubation).
Methods:
We studied 30 nonpremedicated children, aged 2-10 yr, undergoing plastic surgery. They were allocated randomly to five groups (end-tidal sevoflurane concentrations: 2.0, 2.5, 3.0, 3.5, 4.0%). After surgery, 60% nitrous oxide was discontinued and the target concentration of sevoflurane was maintained for at least 10 min in 100% oxygen, then the trachea was extubated to determine MACextubation. Logistic regression was used to estimate MACextubation of sevoflurane.
Results:
MACextubation was 2.3 (0.2; standard error)% (95% confidence limits: 1.2% and 2.7%).
Conclusions:
Tracheal extubation in 50% of anaesthetized children age 2-10 yr may be accomplished without coughing or moving at 2.3% end-tidal concentration of sevoflurane.